Ml I

Annulus

Isovolumetric Relaxation

Fig. 27. Intracavitary isovolumetric relaxation time (IVRT) flow. (A) Asynchronous relaxation of the hypertrophied ventricle is common in hypertrophic cardiomyopathy. Early relaxation of the apical anterior segments can create low (suction) pressure regions within the left ventricular cavity during the IVRT. This resulted in a complex pattern of flow that appeared triphasic (top panels; B). Systolic midcavity obstruction can result in bidirectional flow as shown on color flow Doppler (bottom left panel). Color M-mode of mitral inflow pattern in this patient shows an irregular filling pattern (bottom right panel). (B) Sketch depicting the intracavity IVRT flow patterns on spectral Doppler discussed in Fig. 26A.

Fig. 27. Intracavitary isovolumetric relaxation time (IVRT) flow. (A) Asynchronous relaxation of the hypertrophied ventricle is common in hypertrophic cardiomyopathy. Early relaxation of the apical anterior segments can create low (suction) pressure regions within the left ventricular cavity during the IVRT. This resulted in a complex pattern of flow that appeared triphasic (top panels; B). Systolic midcavity obstruction can result in bidirectional flow as shown on color flow Doppler (bottom left panel). Color M-mode of mitral inflow pattern in this patient shows an irregular filling pattern (bottom right panel). (B) Sketch depicting the intracavity IVRT flow patterns on spectral Doppler discussed in Fig. 26A.

Fig. 26. (Opposite page) A 12-lead electrocardiogram in a 65-yr-old male with coronary artery disease, hyperlipidemia, and type 2 diabetes. A 12-lead electrocardiogram in this patient with apical variant hypertrophic cardiomyopathy shows normal sinus rhythm, left atrial enlargement, increased QRS voltage, and deep T-wave inversion in the precordial leads.

Fig. 28. Doppler indices of diastolic function in apical hypertrophic cardiomyopathy. Mitral inflow Doppler velocity profile in 65-yr-old male suggests mild left ventricular relaxation abnormality (A) with relatively normal pulmonary venous flow Doppler (B). Relatively low velocities are seen on Doppler tissue imaging with reversal of the normal Em: Am ratio (C) and blunted Vp slope on color flow propagation velocity M-mode (D).

Doctor Bernard Bulwer

Was this article helpful?

0 0
Your Heart and Nutrition

Your Heart and Nutrition

Prevention is better than a cure. Learn how to cherish your heart by taking the necessary means to keep it pumping healthily and steadily through your life.

Get My Free Ebook


Post a comment